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Oceanside
man died after appendectomy in 2003
By David Hasemyer
UNION-TRIBUNE STAFF WRITER

November
27, 2004

A
54-year-old Oceanside man bled to death after a
routine appendectomy
at Kaiser Permanente Hospital in San Diego because his doctor made a
mistake,
according to a Medical Board of California accusation filed against the
doctor.

When
Alipati Paopao doubled over and died on his
living room floor in
January 2003, more than two-thirds of his blood had leaked into his
belly
after the operation.

According
to the Medical Board's accusation, the
doctor who performed
the surgery overlooked critical signs that Paopao, who had recently
been
diagnosed with leukemia, was at risk for excessive bleeding.

Dr.
Archana Kudva faces revocation or suspension of
her license by the
medical board, which in October accused her of negligence and
incompetence
in connection with Paopao's death.

Kudva,
a 1993 graduate of Tufts University School of
Medicine in Boston,
declined to discuss the accusation, a Kaiser spokeswoman said.

The
medical board will seek an initial hearing for
Kudva before an administrative
law judge in the next few months.

Paopao
was known as "Uncle Buck" in a family of 10
brothers and sisters
and 58 nieces and nephews.

"He
was one of those kinds of people you naturally
turned to," said
his brother, Tony Paopao.

Alipati
Paopao was born in American Samona and came
to the United States
as a boy, settling in North County with his family. He played football
at Oceanside High School and was a paratrooper in the Army, his brother
said.

Once out of the service, Paopao
married and had a
daughter, who recently
enrolled at California State University Fullerton.

He
was a roofer by trade and a free spirit by
nature, Tony Paopao said.

He
also was sick, more ill than either Paopao or his
family knew.

Alipati
Paopao had an appendicitis attack in October
2002 and was treated
for a week at Kaiser Permanente Hospital. He was sent home after being
scheduled for a laparoscopic appendectomy in January 2003.

During
that initial hospital stay, doctors suspected
Paopao may have
had leukemia. But it wasn't until mid-January, when Paopao spent
another
week in the hospital because of persistent pain in his stomach, that
the
disease was diagnosed, according to the medical board accusation filed
in Administrative Law Court.

Paopao
wasn't told he had leukemia when he returned
for the appendectomy
Jan. 30, 2003, according to a San Diego County Medical Examiner's
report.

Kudva,
who has been licensed in the state since
1995, performed the
laparoscopic procedure. A small incision was made in Paopao's stomach
and
instruments inserted into the abdomen though the small hole.

Kudva
told an investigator from the medical
examiner's office that she
had screened Paopao's blood for its clotting quality and the surgery
was
performed "without any complications."

According
to the medical examiner's report, Paopao
experienced "a great
deal of pain in his abdomen" immediately after the surgery.

Despite
his pain, he was cleared to return home a
few hours after the
surgery with a prescription for two painkillers. He "continued to
experience
uncontrolled pain," according to the medical examiner's report, and he
collapsed shortly before 11 p.m. He was pronounced dead a half-hour
later.

An
autopsy revealed he bled to death from where his
appendix had been
removed.

The
medical board accusation, which is posted on the
board's Web site,
says Kudva should have known Paopao might be susceptible to bleeding
because
leukemia reduces the body's production of cells that help the blood
clot.
Paopao's spleen was enlarged to six times its normal size, indicating
that
it was attacking those cells that aid in coagulation, medical
authorities
said.

The
doctor also was faulted for not keeping Paopao
in the hospital for
overnight observation.

OCEANSIDE, Calif. (AP) - A Kaiser
Permanente doctor
has been cleared
of allegations that one of her patients bled to death after surgery
because
she overlooked a medical condition that put him at risk for excessive
bleeding.

The
Medical Board of California had accused Dr.
Archana Kudva of negligence
and incompetence in connection with the death of Alipati Paopao, 54, of
the Oceanside area, in 2003.

State
medical officials said the doctor failed to
recognize symptoms
and ignored tests that showed Paopao's blood might not clot properly.

After
ruling in Kudva's favor, Judge Alan S. Meth
ordered the dismissal
of the state's accusation, saying the doctor had no reason to believe
her
patient was in danger of bleeding to death.
The judge's order, which became effective Dec. 12, means the
Medical
Board will clear Kudva's record of the accusation.

"Dr. Kudva is greatly relieved
by having the
terrible cloud lifted from
her reputation," said her attorney, Russell Iungerich.